JUYOUNG AN DMD Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****74

License Status

NOT RENEWED

Business

Title

DMD

First Name

JUYOUNG

Last Name

Business Name

JUYOUNG AN DMD

Original Issue Date

04/13/2015

Effective Date

04/13/2015

Expiration Date

09/30/2015

City

PROVIDENCE

State

Zip

02903

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

02/08/2016